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The value of a new image classification system for planning treatment and prognosis of spontaneous isolated superior mesenteric artery dissection.
Vascular 2015; 23(5):504-12V

Abstract

OBJECTIVE

To aid diagnosis of spontaneous isolated superior mesenteric artery dissection and planning management, we investigated the role of classification of features as observed on computed tomography angiography images.

METHODS

A retrospective study was conducted, comprising computed tomography angiography images and clinical data of 28 consecutive patients with spontaneous isolated superior mesenteric artery dissection. Based on the computed tomography angiography images, a new classification for spontaneous isolated superior mesenteric artery dissection was proposed. Patients with intestinal ischemia not relieved or worsened after 10 days of conservative treatment underwent surgery or stenting. All patients were followed up with computed tomography angiography.

RESULTS

Spontaneous isolated superior mesenteric artery dissection was categorized into five types (I-V). Type III was further divided into subtypes IIIa-IIIc. Spontaneous isolated superior mesenteric artery dissection IIIa and IV typified nine (32.1%) and seven (25%) patients, respectively. Six (21.4%) patients had aortic or branch artery abnormalities and 21 (78%) showed prior intestinal ischemia. Four (14.3%) patients had intestinal ischemia and underwent surgery or stenting.

CONCLUSIONS

Spontaneous isolated superior mesenteric artery dissection type IIIa is more likely to occur than other types. Long-term computed tomography angiography follow-up is valuable for determining treatment strategy for spontaneous isolated superior mesenteric artery dissection. Conservative therapy with anticoagulants is recommended for five days, and surgery or stenting should be considered if symptoms of intestinal ischemia are not relieved. Stent implantation provides relatively satisfactory mid-term outcome for true lumen construction of the superior mesenteric artery.

Authors+Show Affiliations

Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China xiongjiangdoc@126.com.Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.Department of Vascular Surgery, Chinese PLA General Hospital, Beijing, P.R. China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26038122

Citation

Xiong, Jiang, et al. "The Value of a New Image Classification System for Planning Treatment and Prognosis of Spontaneous Isolated Superior Mesenteric Artery Dissection." Vascular, vol. 23, no. 5, 2015, pp. 504-12.
Xiong J, Wu Z, Guo W, et al. The value of a new image classification system for planning treatment and prognosis of spontaneous isolated superior mesenteric artery dissection. Vascular. 2015;23(5):504-12.
Xiong, J., Wu, Z., Guo, W., Liu, X., Wang, L., Zhang, H., ... Ma, X. (2015). The value of a new image classification system for planning treatment and prognosis of spontaneous isolated superior mesenteric artery dissection. Vascular, 23(5), pp. 504-12. doi:10.1177/1708538115589527.
Xiong J, et al. The Value of a New Image Classification System for Planning Treatment and Prognosis of Spontaneous Isolated Superior Mesenteric Artery Dissection. Vascular. 2015;23(5):504-12. PubMed PMID: 26038122.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The value of a new image classification system for planning treatment and prognosis of spontaneous isolated superior mesenteric artery dissection. AU - Xiong,Jiang, AU - Wu,Zhongyin, AU - Guo,Wei, AU - Liu,Xiaoping, AU - Wang,Lijun, AU - Zhang,Hongpeng, AU - Jia,Xin, AU - Ma,Xiaohui, Y1 - 2015/06/01/ PY - 2015/6/4/entrez PY - 2015/6/4/pubmed PY - 2016/7/12/medline KW - Superior mesenteric artery KW - computed tomography angiography KW - spontaneous isolated superior mesenteric artery dissection KW - treatment strategy SP - 504 EP - 12 JF - Vascular JO - Vascular VL - 23 IS - 5 N2 - OBJECTIVE: To aid diagnosis of spontaneous isolated superior mesenteric artery dissection and planning management, we investigated the role of classification of features as observed on computed tomography angiography images. METHODS: A retrospective study was conducted, comprising computed tomography angiography images and clinical data of 28 consecutive patients with spontaneous isolated superior mesenteric artery dissection. Based on the computed tomography angiography images, a new classification for spontaneous isolated superior mesenteric artery dissection was proposed. Patients with intestinal ischemia not relieved or worsened after 10 days of conservative treatment underwent surgery or stenting. All patients were followed up with computed tomography angiography. RESULTS: Spontaneous isolated superior mesenteric artery dissection was categorized into five types (I-V). Type III was further divided into subtypes IIIa-IIIc. Spontaneous isolated superior mesenteric artery dissection IIIa and IV typified nine (32.1%) and seven (25%) patients, respectively. Six (21.4%) patients had aortic or branch artery abnormalities and 21 (78%) showed prior intestinal ischemia. Four (14.3%) patients had intestinal ischemia and underwent surgery or stenting. CONCLUSIONS: Spontaneous isolated superior mesenteric artery dissection type IIIa is more likely to occur than other types. Long-term computed tomography angiography follow-up is valuable for determining treatment strategy for spontaneous isolated superior mesenteric artery dissection. Conservative therapy with anticoagulants is recommended for five days, and surgery or stenting should be considered if symptoms of intestinal ischemia are not relieved. Stent implantation provides relatively satisfactory mid-term outcome for true lumen construction of the superior mesenteric artery. SN - 1708-539X UR - https://www.unboundmedicine.com/medline/citation/26038122/The_value_of_a_new_image_classification_system_for_planning_treatment_and_prognosis_of_spontaneous_isolated_superior_mesenteric_artery_dissection_ L2 - http://journals.sagepub.com/doi/full/10.1177/1708538115589527?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -